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2.
Bull World Health Organ ; 98(6): 382-393, 2020 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-32514212

RESUMO

Objective: To develop a method to assess the cost of extending the duration of maternity leave for formally-employed women at the national level and apply it in Brazil, Ghana and Mexico. Methods: We adapted a World Bank costing method into a five-step method to estimate the costs of extending the length of maternity leave mandates. Our method used the unit cost of maternity leave based on working women's weekly wages; the number of additional weeks of maternity leave to be analysed for a given year; and the weighted population of women of reproductive and legal working age in a given country in that year. We weighted the population by the probability of having a baby that year among women in formal employment, according to individual characteristics. We applied nationally representative cross-sectional data from fertility, employment and population surveys to estimate the costs of maternity leave for mothers employed in the formal sector in Brazil, Ghana and Mexico for periods from 12 weeks up to 26 weeks, the WHO target for exclusive breastfeeding. Findings: We estimated that 640 742 women in Brazil, 33 869 in Ghana and 288 655 in Mexico would require formal maternity leave annually. The median weekly cost of extending maternity leave for formally working women was purchasing power parity international dollars (PPP$) 195.07 per woman in Brazil, PPP$ 109.68 in Ghana and PPP$ 168.83 in Mexico. Conclusion: Our costing method could facilitate evidence-based policy decisions across countries to improve maternity protection benefits and support breastfeeding.


Assuntos
Aleitamento Materno/economia , Licença Parental/economia , Mulheres Trabalhadoras , Brasil , Estudos Transversais , Feminino , Gana , Humanos , México , Modelos Econométricos , Fatores Socioeconômicos
6.
Scand J Public Health ; 48(2): 164-171, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30973064

RESUMO

Aims: To examine gender equality in the family and sick leave among first-time parents. Methods: Heterosexuals who became first-time parents between 2002 and 2009 (N = 223,332) were identified in national registers. Gender equality in the family was evaluated by parental insurance and income from gainful employment representing the domestic and work spheres respectively and was defined as each parent contributing 40-60% of the family total. The risk of a new medically certified sick-leave spell (>14 days) was evaluated by hazard ratio (HR) using the Cox proportional hazard regression, adjusted for demographic and socioeconomic factors. Results: Gender equality was associated with an increased risk of sick leave compared with traditional roles where women had the main responsibility in the domestic sphere and men in the work sphere (HR 1.30 in women and 1.19 in men). In addition, situations with one partner exposed to double burden or untraditional settings were associated with an increased risk. Conclusions: Equal sharing or taking the lion's share of paid work and domestic responsibilities were associated with an increased risk of sick leave among first-time parents in Sweden. Family-friendly policies are important for facilitating the life of dual earner families, but do not fully counteract the work-life demands of first-time parents.


Assuntos
Licença Parental/estatística & dados numéricos , Fatores Sexuais , Licença Médica/estatística & dados numéricos , Equilíbrio Trabalho-Vida , Adulto , Feminino , Identidade de Gênero , Humanos , Masculino , Estudos Prospectivos , Sistema de Registros , Fatores de Risco , Suécia
8.
Plast Reconstr Surg ; 144(5): 1227-1236, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31688771

RESUMO

BACKGROUND: Plastic surgery trainees who wish to start a family face challenges. This is the first study to collect data directly from residents and fellows to understand issues surrounding childbearing and to propose solutions. METHODS: Following institutional review board approval, an anonymous survey was distributed to all current plastic surgery residents and fellows in the United States. Data regarding demographics, obstetrical complications, parental leave, breastfeeding, and use of assisted reproductive technology were collected. RESULTS: The survey was completed by 307 trainees, for a resident response rate of 27.0 percent. Mean age of the respondents was 31.7 ± 3.8 years, 58.6 percent were married, and 35.3 percent reported at least one pregnancy for themselves or for their partner. Both male (67.4 percent) and female (76.5 percent) respondents intentionally postponed having children because of career. Women were significantly more likely to report negative stigma attached to pregnancy (70.4 percent versus 51.1 percent; p = 0.003) and plan to delay childbearing until after training. Fifty-six percent of female trainees reported an obstetrical complication. Assisted reproductive technology was used by 19.6 percent of trainees. Mean maternity leave was 5.5 weeks, with 44.4 percent taking less than 6 weeks. Mean paternity leave was 1.2 weeks. Sixty-two percent of women and 51.4 percent of men reported dissatisfaction with leave. Sixty-one percent of female trainees breastfed for 6 months and 19.5 percent continued for 12 months. Lactation facilities were available near operating rooms for 29.4 percent of respondents. CONCLUSIONS: Plastic surgery training may negatively impact fertility, obstetrical health, and breastfeeding practices. The data presented in this article provide the groundwork for identifying areas of concern and potential solutions.


Assuntos
Escolha da Profissão , Educação de Pós-Graduação em Medicina/organização & administração , Serviços de Planejamento Familiar/métodos , Licença Parental/normas , Médicas/estatística & dados numéricos , Cirurgia Plástica/educação , Adulto , Atitude do Pessoal de Saúde , Estudos Transversais , Feminino , Humanos , Internato e Residência/métodos , Masculino , Saúde Materna , Determinação de Necessidades de Cuidados de Saúde , Licença Parental/tendências , Gravidez , Fatores de Risco , Fatores de Tempo , Estados Unidos
9.
Kaku Igaku ; 56(1): 157-159, 2019.
Artigo em Japonês | MEDLINE | ID: mdl-31685756

RESUMO

Women physicians, scientists and nurses are addressing many problems encountered in the practice of their chosen fields. We carried out a survey of the women working in the nuclear medicine field. Two hundred and six professionals answered this questionnaire. The findings of our survey were that we have many female bosses (experts), a low number of sexual harassment issues and enough parental leave. Many members work very hard to practice in this field, but they do not have enough support from their hospitals or research centers, to join medical conferences. And almost a quarter of those surveyed thought it is hard to improve their careers after taking parental leave. A change of perception in how their male colleagues and counterparts regard women in the field of nuclear medicine is required. This change, along with women having a clear and realistic career plan are fundamental answers to the issues faced by women in nuclear medicine.


Assuntos
Escolha da Profissão , Mobilidade Ocupacional , Satisfação no Emprego , Medicina Nuclear , Enfermeiras e Enfermeiros/psicologia , Saúde do Trabalhador , Médicas/psicologia , Saúde da Mulher , Local de Trabalho/psicologia , Feminino , Humanos , Japão/epidemiologia , Licença Parental/estatística & dados numéricos , Sexismo , Assédio Sexual/estatística & dados numéricos , Apoio Social , Inquéritos e Questionários
10.
Gac. sanit. (Barc., Ed. impr.) ; 33(5): 455-461, sept.-oct. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-189020

RESUMO

Objetivo: Estudiar la utilización de la prestación por riesgo durante el embarazo (PRE) y de la incapacidad temporal por contingencia común (ITcc) en una cohorte de trabajadoras embarazadas del Parc de Salut Mar, Barcelona (España). Método: Estudio de cohorte retrospectiva de 428 trabajadoras embarazadas entre 2010 y 2014, que fueron seguidas hasta el parto, registrando las ausencias por ITcc o PRE hasta el inicio de su licencia por maternidad. El análisis de secuencias identifica cuatro trayectorias, que son descritas según las características demográficas y laborales de las trabajadoras. Resultados: Del total de mujeres, 56 (13,1%) accedieron únicamente a la PRE, que representó 6126 días de ausencia; 68 (15,9%) también accedieron a la PRE, con 7127 días de ausencia, pero con anterioridad habían acumulado 102 episodios de ITcc con 1820 días de ausencia. La mayoría de las trabajadoras embarazadas de la muestra (69,9%) se acogió solo a uno o varios episodios de ITcc sin utilizar la PRE, con 545 episodios y 26337 días de ausencia. La mayoría estuvieron activas laboralmente durante el primer trimestre y es a partir del segundo cuando aparecieron episodios de ITcc de larga duración. El último mes del embarazo, más del 80% de las trabajadoras estaban ausentes del trabajo. Conclusiones: Las trabajadoras embarazadas permanecen activas dos terceras partes del embarazo. Las ausencias se deben mayoritariamente a episodios de ITcc, representando la PRE una tercera parte. Nuestros resultados sugieren, como ocurre en otros países de nuestro entorno, un cambio en la gestión de la protección social de las trabajadoras embarazadas


Objective: To study the use of the Pregnancy occupational risk benefit (PORB) and non-work related sickness absence (NWSA) in a cohort of pregnant workers of Parc de Salut Mar, Barcelona (Spain). Method: Retrospective cohort study of 428 pregnant workers between 2010 and 2014, who were followed-up until delivery. Absences from work, both PORB and NWSA were recorded until the beginning of their maternity leave. The sequence analysis identifies four trajectories, which are described according to workers demographic and job characteristics. Results: Of the total cohort, 56 (13.1%) accessed only the PORB, representing 6.126 days of absence; 68 (15.9%) also accessed PORB, with 7.127 days of absence, but had previously accumulated 102 episodes of NWSA with 1.820 days of absence. The majority of pregnant workers in the sample (69.9%) took only one or several episodes of NWSA without using PORB, with 545 episodes and 26,337 days of absence. Most were active during the first quarter and it is from the second quarter that episodes of long-term NWSA appeared. During the last month of pregnancy more than 80% of the workers were absent from work. Conclusions: Pregnant workers remained at work for two thirds of their pregnancy. Absences were mainly due to episodes of NWSA. PORB represented one third of them. As in other similar countries, our results suggest a change in the management of social protection benefits for pregnant workers


Assuntos
Humanos , Feminino , Gravidez , Adulto , Complicações na Gravidez/epidemiologia , Licença Médica/estatística & dados numéricos , Assistência à Saúde/estatística & dados numéricos , Estudos Retrospectivos , Fatores de Risco , Riscos Ocupacionais , Maternidades/estatística & dados numéricos , Licença Parental/estatística & dados numéricos
11.
PLoS One ; 14(9): e0221150, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31509544

RESUMO

INTRODUCTION: According to the International Labor Organization, Maternity Protection (MP) policies try to harmonize child care and women's paid work, without affecting family health and economic security. Chile Law 20.545 (2011) increased benefits for economically active women and reduced requirements for accessing these benefits. The goals of the reform included: 1) to increase MP coverage; and 2) to reduce inequities in access to the benefits. METHOD: This study uses two data sources. First, using individual data routinely collected from 2000 to 2015, yearly MP coverage access over time was calculated. Second, using national representative household surveys collected before and after the Law (2009 and 2013), coverage and a set of measures of inequality were estimated. To compare changes over time, we used non-experimental, before-after intervention design for independent samples. For each variable, we estimated comparative proportions at 95% confidence interval before and after the intervention. Additionally, we included multivariate and propensity score analysis. RESULTS: Between 2000 and 2015, MP coverage grew from 24.4% to 44.8%. Using comparable 2009 and 2013 survey data, we observed the same trend, with 31.6% of estimated MP coverage in 2009, escalating to 39.5% in 2013. We conclude that: 1) after the reform, there was an increase in MP coverage; and, 2) there was no significant reduction of inequities in the distribution of MP benefits. DISCUSSION/CONCLUSION: Few scientific evaluations of MP reforms have been conducted worldwide; even fewer including an equity analysis. This study provides an empirically-based evaluation of MP reform from both a population-level and an equity-focused perspective. We conclude that this reform needs to be complemented with other policies to ensure maternity protection in terms of access and equity in a country with deep socioeconomic stratification.


Assuntos
Saúde Materna/legislação & jurisprudência , Licença Parental/economia , Adolescente , Adulto , Distribuição por Idade , Chile , Feminino , Reforma dos Serviços de Saúde , Política de Saúde , Acesso aos Serviços de Saúde , Disparidades em Assistência à Saúde , Humanos , Análise Multivariada , Pontuação de Propensão , Mulheres Trabalhadoras , Adulto Jovem
13.
Fam Med ; 51(9): 742-749, 2019 Oct 04.
Artigo em Inglês | MEDLINE | ID: mdl-31465110

RESUMO

BACKGROUND AND OBJECTIVES: Adequate parental leave policies promote a supportive workplace environment. This study describes how US family medicine (FM) residency program parental leave policies compare to reported leave taken by residents and faculty. METHODS: This is a descriptive study of questions from a 2017 Council of Academic Medicine Educational Research Alliance (CERA) survey of accredited US FM program directors. RESULTS: The overall survey response rate was 54.6% (261/478). Paid maternity leave policies varied widely (0 to >12 weeks; mean=5.3 weeks for faculty and 4.5 weeks for residents); paid paternity leave ranged from 0 to 12 weeks (mean=2.7 weeks for faculty and 2.4 weeks for residents). Some FM programs reported offering residents (29.1%) and faculty (28.5%) no paid maternity leave; 37.2% offered residents and 40.4% offered faculty no paid paternity leave. Both female and male faculty took significantly less leave than was offered (maternity leave: faculty 0.6 weeks less, P<.01; residents 0.5 weeks less, P<.01; paternity leave: faculty 1.6 weeks less, P<.01; residents 0.6 weeks less, P<.01). The amount of paid and total maternity and paternity leave surrendered by residents was strongly correlated with the amount surrendered by faculty in the same program (correlation coefficients 0.46-0.87, P<.01). Residents in smaller programs, and programs with a rural focus, surrendered more parental leave. CONCLUSIONS: Programs vary widely in their parental leave offerings, and FM residents and faculty frequently take less parental leave than offered. As the amount of leave taken by residents and faculty at the same institution is correlated, institutional culture may contribute to parental leave use.


Assuntos
Medicina de Família e Comunidade/educação , Internato e Residência , Política Organizacional , Licença Parental/estatística & dados numéricos , Adulto , Feminino , Humanos , Masculino , Cultura Organizacional , Inquéritos e Questionários
14.
J Grad Med Educ ; 11(4): 472-474, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31440344

RESUMO

Background: Of the top 15 medical schools with affiliated graduate medical education (GME) programs, 8 offer paid parental leave, with an average duration of 6.6 weeks. It is not known how other GME programs approach parental leave. Objective: We searched for the parental leave policies for residents in programs affiliated with the top 50 medical schools. Methods: In 2019, we identified the top 50 medical schools designated by US News & World Report in the research and primary care categories (totaling 59 schools), and identified the associated GME programs. For each school, we accessed its website and searched for "GME Policies and Procedures" to find language related to maternity, paternity, or parental leave, or the Family Medical Leave Act. If unavailable, we e-mailed the GME office to identify the policy. Results: Of 59 schools, 25 (42%) described paid parental leave policies with an average of 5.1 weeks paid leave; 11 of those (44%) offer ≤ 4 weeks paid parental leave. Twenty-five of 59 (42%) programs did not have paid parental leave, but 13 of these specify that residents can use sick or vacation time to pay for part of their parental leave. Finally, 13 of 59 (22%) offered state mandated partial paid leave. One school did not have any description of parental leave. Conclusions: While paid parental leave for residents has been adopted by many of the GME programs affiliated with the top 50 medical schools, it is not yet a standard benefit offered to the majority of residents.


Assuntos
Internato e Residência , Licença Parental/normas , Equilíbrio Trabalho-Vida , Educação de Pós-Graduação em Medicina , Feminino , Humanos , Masculino , Licença Parental/economia , Fatores de Tempo
15.
Am J Surg ; 218(4): 772-779, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31376951

RESUMO

BACKGROUND: The aim of this study is to evaluate the components of current parental leave policies in surgical practice and evaluate surgeon perceptions of parental leave. METHODS: Practicing surgeons were recruited to complete a survey via social media outlets and e-mail. Participants were asked questions regarding existing policies and their perspectives towards parental leave. RESULTS: The survey was completed by 431 surgeons, of which 90% were female and 45% in academics. The majority (84%) of women took <12 weeks leave, and 24% were fully funded. All male respondents took <4 weeks, of which 55% was fully paid. Discrimination was experienced by 31%. The majority support paid parental leave (94%) without impact on time to promotion (87%) or partnership (85%). CONCLUSIONS: There is variance in current parental leave policies regarding length and compensation. Most respondents support paid parental leave and are in favor of policies that support new parents during and after pregnancy.


Assuntos
Atitude do Pessoal de Saúde , Política Organizacional , Licença Parental , Especialidades Cirúrgicas , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários
16.
Postgrad Med J ; 95(1128): 552-557, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31375558

RESUMO

BACKGROUND: Internationally, supporting surgical trainees during pregnancy, maternity and paternity leave is essential for trainee well-being and for retention of high-calibre surgeons, regardless of their parental status. This study sought to determine the current experience of surgical trainees regarding pregnancy, maternity and paternity leave. METHODS: A cross-sectional anonymised electronic voluntary survey of all surgical trainees working in the UK and Ireland was distributed via the Association of Surgeons in Training and the British Orthopaedic Trainees' Association. RESULTS: There were 876 complete responses, of whom 61.4% (n=555) were female. 46.5% (258/555) had been pregnant during surgical training. The majority (51.9%, n=134/258) stopped night on-call shifts by 30 weeks' gestation. The most common reason for this was concerns related to tiredness and maternal health. 41% did not have rest facilities available on night shifts. 27.1% (n=70/258) of trainees did not feel supported by their department during pregnancy, and 17.1% (n=50/258) found the process of arranging maternity leave difficult or very difficult. 61% (n=118/193) of trainees felt they had returned to their normal level of working within 6 months of returning to work after maternity leave, while a significant minority took longer. 25% (n=33/135) of trainees found arranging paternity leave difficult or very difficult, and the most common source of information regarding paternity leave was other trainees. CONCLUSION: Over a quarter of surgical trainees felt unsupported by their department during pregnancy, while a quarter of male trainees experience difficulty in arranging paternity leave. Efforts must be made to ensure support is available in pregnancy and maternity/paternity leave.


Assuntos
Internato e Residência , Licença Parental , Adulto , Atitude do Pessoal de Saúde , Estudos Transversais , Feminino , Humanos , Irlanda , Masculino , Política Organizacional , Admissão e Escalonamento de Pessoal , Gravidez , Inquéritos e Questionários , Reino Unido
17.
Am J Surg ; 218(4): 798-802, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31395271

RESUMO

BACKGROUND: As women become a larger part of the surgical workforce, policies surrounding maternity and parental leave play a role in professional practice. Little is known about leave policies worldwide. METHODS: A de novo survey distributed internationally to women surgeons assessed leave polices for surgeons, inclusive of the regulatory body or source of applicable policies, changes in surgical practice due to pregnancy, and duration of leave for both parents. RESULTS: The 1111 survey respondents in 53 different countries describe diverse policies ranging from loss of operating room privileges early in pregnancy to maintenance of full surgical schedules until term delivery. Policy creators include national governments (42.38%), employers/hospitals (60.46%), supervisors (18.06%). Self-determined (9.12%), and unknown (8.7%). Paid parental leave was available to 64.44% of women surgeons and 38.68% of partners. CONCLUSION: Maternity and parental leave policies vary markedly across the global surgical workforce with implications for professional practice.


Assuntos
Política Organizacional , Licença Parental , Administração da Prática Médica , Especialidades Cirúrgicas , Adulto , Atitude do Pessoal de Saúde , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Gravidez , Inquéritos e Questionários , Adulto Jovem
18.
Pediatrics ; 144(2)2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31331985

RESUMO

BACKGROUND AND OBJECTIVES: In 2016, the Department of Defense extended maternity leave from 6 to 12 weeks for active duty mothers to support breastfeeding initiation and duration. Limited data exist regarding the impact of prolonged maternity leave. Our objective was to evaluate the prolongation of maternity leave on the initiation and duration of breastfeeding in active duty mothers. METHODS: In this single-center retrospective cohort study, we used data collected from Department of Defense electronic health care records of infants born to active duty mothers who were delivered during calendar years 2014 and 2016. The primary outcomes were initiation and duration of breastfeeding and breastfeeding exclusivity evaluated throughout the first year of life. Secondary outcomes were differences in breastfeeding rates between military-branch affiliation and military rank. RESULTS: No changes in breastfeeding initiation occurred between the 2 cohorts (n = 423 and 434). However, an increase in breastfeeding establishment was identified at the 2- (81.5% vs 72.4%; P = .002), 4- (70.5% vs 56.7%; P < .001), 6- (60.3% vs 46.5%; P < .001), and 9-month (45.4% vs 34.9%; P = .003) visits in the 12-week leave cohort. Exclusive breastfeeding increased at 2 (56.4% vs 47.2%; P = .007), 4 (47.5% vs 36.4%; P = .001), and 6 (37.3% vs 29.3%; P = .016) months. CONCLUSIONS: Increases in maternity leave correlated with increased breastfeeding duration and exclusivity through 9 months for active duty mothers. These data support the benefit of extended maternity leave in the military and the need for future studies to validate findings at other military treatment facilities.


Assuntos
Aleitamento Materno/tendências , Registros Eletrônicos de Saúde/tendências , Militares , Mães , Licença Parental/tendências , Adolescente , Adulto , Aleitamento Materno/métodos , Estudos de Coortes , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Estudos Retrospectivos , Adulto Jovem
19.
Acad Med ; 94(11): 1654-1657, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31299674

RESUMO

Parents taking leave after the birth of a child is associated with significant benefits for infants, mothers, and fathers. Although nearly 40% of residents have or plan to have children during residency, there is no standard parental leave policy for these trainees. In this Perspective, the authors discuss the benefits of parental leave, synthesize findings about maternity bias and other negative effects of the current variable approaches to parental leave during residency, and explore underlying causes of the lack of a standard parental leave policy for residents. They also call on the Accreditation Council for Graduate Medical Education and the American Board of Medical Specialties to work together to address this issue, recommending a standard parental leave policy that ensures a minimum of 8 weeks of paid leave for all residents without requiring them to extend training or making them ineligible to sit for board certification exams. Creating evidence-based and family-friendly guidelines for parental leave is important to the progress of academic medicine in the modern era, as it supports parental and child health, promotes resident wellness, and reduces gender disparities in medicine to the benefit of all.


Assuntos
Educação de Pós-Graduação em Medicina/organização & administração , Internato e Residência/organização & administração , Política Organizacional , Licença Parental/legislação & jurisprudência , Pais , Médicos/organização & administração , Humanos
20.
Artigo em Inglês | MEDLINE | ID: mdl-31319561

RESUMO

Korea is facing problems, such as inequality within society and an aging population, that places a burden on public health expenditure. The active adoption of policies that promote work-family balance (WFB), such as parental leave and workplace childcare centers, is known to help solve these problems. However, there has, as yet, been little quantitative evidence accumulated to support this notion. This study used the choice experiment methodology on 373 Koreans in their twenties and thirties, to estimate the level of utility derived from work-family balance policies. The results show that willingness to pay for parental leave was found to be valued at 7.81 million Korean won, while it was 4.83 million won for workplace childcare centers. In particular, WFB policies were found to benefit workers of lower socioeconomic status or belonging to disadvantaged groups, such as women, those with low education levels, and those with low incomes. Furthermore, the utility derived from WFB policies was found to be greater among those who desire children compared to those who do not. The results suggest that the proactive introduction of WFB policies will help solve problems such as inequality within society and population aging.


Assuntos
Creches/economia , Licença Parental/economia , Equilíbrio Trabalho-Vida/economia , Local de Trabalho/psicologia , Adulto , Algoritmos , Pré-Escolar , Feminino , Humanos , República da Coreia , Fatores Socioeconômicos , Local de Trabalho/economia , Adulto Jovem
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